1. Temporal Exploration of EHRs Using the i2b2 Open Source Platform Vivian Gainer Partners Healthcare

2. In the Beginning …

3. Returning Data to Investigators Output files placed in special directory Files include a Microsoft Access Database Identified data is gathered from RPDR and other Partners sources

4. Researchers’ Wish List To view many patients at a time To have a complete view of a patient’s data To view a patient over time To view patient text notes in the application To add power to the notes via NLP To annotate the data To save and reuse work

5. Our Wish List An open source framework that is: Easy to use for a variety of users Scalable Extensible Robust Interoperable Platform-independent HIPAA-compliant

6. Tools and Architecture i2b2 HIVE: Service-Oriented Architecture XML messages Cells Eclipse (plug-ins)

7. Process

8. i2b2 Workbench

9. User Interactions Diagnosis Asthma Diabetes Test Glucose PFT Demographics Age Sex Browse Concepts DiabetesAsthma Patient Set Query Age Sex Patient Data Query Patient Set Patient Data Patient 1: 63 year Male Patient 2: 48 year Female Patient 3: 24 year Male

10. Browse concepts

11. Create a Query

12. Create a model for the Timeline

13. Timeline

14. View a text report

15. Parse the text report

16. HELP

17. Add another plug-in: TableView http://ccgb.umn.edu/software/java/apps/TableView/ http://ccgb.umn.edu/software/java/apps/TableView/

18. The workbench and timeline allow users to: survey the data to see what is available check data integrity for obvious anomalies compare data coming from different sources display data concisely on single patients drill down in term hierarchies perform time-oriented queries Show time-oriented averages (trends) within the data using sentinel events to synchronize the starting points.

19. What are we going to do with it? Extend phenotypic data collection Add anonymous specimen repository Add a Bayesian inference engine Predictive modeling Perform clinical trials in-silico Discovering correlations within data (relationship networks) Pharmacovigilance Genomic studies Geograpic Information Systems (GIS) studies …

20. Thanks! HCIL i2b2 Shawn Murphy Mike Mendis Lori Phillips Raj Kuttan Wensong Pan Janice Donahoe